Squamous cell carcinoma is a skin cancer that attacks squamous cells, which are cells that form the middle and outer layers of the skin. This cancer usually appears on the face, neck, hands and feet.
Squamous cell carcinoma (SCC) ranks second for the most common type of skin cancer . Although it usually appears on areas of the skin that are often exposed to sunlight, KSS can also attack other parts of the body that have squamous cells.
Squamous cell carcinoma is a type of skin cancer that tends to grow slowly. However, unlike other skin cancers, this type of cancer can spread to bones and other organs. In this condition, KSS will be more difficult to cure.
Causes of Squamous Cell Carcinoma
SCC is caused by mutations or changes in DNA in squamous cells in the skin. The mutation causes squamous cells to grow uncontrollably and live longer.
Changes to the DNA in squamous cells can be triggered by ultraviolet radiation, such as from direct exposure to sunlight or as a result of procedures to tan the skin with UV light ( tanning the skin).
Squamous Cell Carcinoma Risk Factors
There are a number of factors that can increase the risk of developing squamous cell carcinoma, namely:
- Have light skin
- Have a history of KSS or other types of skin cancer
- Have a history of sunburn as a child or teenager
- Have precancerous lesions, such as solar keratosis or Bowen's disease
- Have a weak immune system, for example because you have leukemia or lymphoma , have recently had an organ transplant, or are currently taking drugs that suppress the immune system (such as corticosteroids)
- Exposure to chemicals, such as arsenic, in the long term
- Have a job exposed to radiation
- Suffering from human papillomavirus ( HPV ) or human immunodeficiency virus ( HIV ) infection
- Have genetic disorders, such as xeroderma pigmentosum , Gorlin syndrome, albinism , and Bazex syndrome
- Excessive exposure to sunlight, for example due to working outdoors
- Use a tanning tool to darken the skin
Symptoms of Squamous Cell Carcinoma
Squamous cell carcinoma generally affects skin exposed to sunlight, such as the scalp, hands, ears and lips. However, symptoms can also appear in other parts of the body, such as in the mouth, soles of the feet, and the genital and anal areas.
The initial symptom of squamous cell carcinoma of the skin is the appearance of red, scaly patches or lumps that feel dry, itchy, and change color (solar keratosis). On the inside of the mouth, such as the tongue, gums or the walls of the mouth, the initial symptoms can be white spots that cannot be cleaned ( leukoplakia ).
If it has developed, signs and symptoms of squamous cell carcinoma that can occur include:
- Hard red bumps that look like warts
- Rough red patches that are crusty, scaly, and bleed easily
- Open wounds that don't heal
- Wounds with raised edges and a wound bed that itch and bleed easily
It should be noted that wounds on the skin that do not heal for a long time or often re-form can also be a sign of squamous cell carcinoma.
When to see a doctor
Check with your doctor if you experience any of the symptoms above, especially if the symptoms don't go away for up to 2 months. The sooner squamous cell carcinoma is detected and treated, the better the chance for recovery.
Diagnosis of Squamous Cell Carcinoma
The doctor will ask about the patient's complaints and symptoms as well as the patient's and family's medical history. Next, the doctor will perform a physical examination of the patient's skin. If a lesion on the skin is suspected as squamous cell carcinoma, the doctor will take a tissue sample ( biopsy ) of the skin for examination in the laboratory.
Squamous cell carcinoma stage
After it is confirmed that the patient has KSS, the doctor will carry out further tests to determine the stage of KSS. This examination will assist the doctor in choosing the right type of treatment for the patient.
The following are the stages or stages of development of squamous cell carcinoma:
Cancer cells are in the top layer of skin (epidermis) and have not spread to the deep layers of the skin
The tumor is less than 2 cm in size and has not spread to the lymph nodes
The tumor is 2–4 cm in size and has not spread to the lymph nodes
The tumor is larger than 4 cm or has spread to the deep layers of the skin, bone, or to nearby lymph nodes
Tumor of any size that has spread to more than 1 lymph node, bone marrow, or other organs
Treatment of Squamous Cell Carcinoma
There are several treatment methods to treat KSS. The method chosen by the doctor will be adjusted to the age and overall health of the patient, the size and area of the affected skin, and the severity of SCC. Some of the methods that can be done are:
1. Electrodessiccation and curettage
Electrodessiccation and curettage is a procedure for removing tumors by means of a curettage. Once removed, the lower layers of the cancer are burned using an electric needle.
Cryosurgery or cryotherapy is a procedure to kill cancer cells using liquid nitrogen. This method can also be done after the curettage.
3. Therapy laser
Laser therapy is a procedure to kill cancer cells using laser light. This method is used on KSS in skin that is not too deep.
4. Photodynamic therapy
This procedure is carried out by administering topical medication in the form of aminolevulinic acid to the skin affected by KSS. The skin that has been smeared with the drug is then irradiated with a special light to destroy cancer cells.
5. Simple excision
Simple excision is a procedure whereby the area of the skin affected by the cancer and the healthy skin tissue around it is cut.
6. Mohs surgery
Mohs surgery is a procedure that removes the affected skin layer by layer and then examines it under a microscope. This method is usually done to remove cancer on the face, nose and ears.
Chemotherapy is a method to kill cancer that has spread to other organs using drugs.
Squamous Cell Carcinoma Complications
If left untreated, squamous cell carcinoma can spread and damage nearby healthy organs and tissues. In some cases, this condition can be life threatening.
Several factors that can increase the risk of patients experiencing organ damage due to KSS are:
- Large cancer size
- Cancer has spread to the deep layers of the skin
- Cancer forms in mucous membranes, such as on the lips or inside of the mouth
- History of organ transplantation
- Weak resistance
Prevention of Squamous Cell Carcinoma
In most cases, squamous cell carcinoma cannot be prevented. However, you can reduce your risk of developing this disease by doing the following:
- Avoid sun exposure when it's hot and change your outdoor activity schedule to hours when the sun is not as hot, if possible
- Wear clothing that can protect all parts of the skin, including hats and glasses, when traveling
- Applying a sunscreen that has at least SPF 30 to the skin every 2 hours when outside, or more frequently when swimming or sweating
- Routinely examine the skin independently and immediately see a doctor when there are suspicious changes in the skin
- Avoid tanning the skin